유세포분석을 이용한 세포질 경쇄 발현 확인으로 단클론성을 증명한 B세포 림프종 1예
A Case of Mature B-cell Neoplasm with Light Chain Clonality Confirmed by Cytoplasmic Light Chain Expression Using Flow Cytometry
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초록
세포표면 면역글로불린의 kappa 또는 lambda 경쇄 제한은 성숙B-세포종양의 단클론성의 증거이다. 하지만 세포표면 면역글로불린 경쇄의 비전형적인 양상은 비특이적인 염색의 결과로 나타날 수도 있기 때문에 해석에 주의해야 한다. 이전의 한 연구에 의하면, 세포질 면역글로불린의 경쇄 발현 패턴의 유세포분석이 성숙B-세포종양의 단클론성을 증명하는 데 도움이 되는 것으로 알려져 있다. 이에 저자들은 세포표면 면역글로불린이 아닌 세포질 면역글로불린의 경쇄 발현 분석으로 성숙B-세포종양의 단클론성이 확인되었던 예를 경험하였기에 이를 소개하고자 한다. 증례는 B세포 림프종으로 세포표면 면역글로불린의 비특이적 경쇄 발현 패턴을 보였다. 본 증례에서와 같이 비전형적인 세포표면 면역글로불린 경쇄 발현 패턴을 보일 경우, 성숙B-세포종양의 단클론성을 확인하기 위해서 세포질 면역글로불린 경쇄 발현 분석을 고려해야 한다.
Abstract
Surface immunoglobulin light-chain restriction is evidence of clonality in mature B-cell neoplasms. An aberrant pattern of surface light-chain expression can also be considered evidence of clonality. However, because this result could occur due to nonspecific staining or failure to stain, careful interpretation is required for accurate diagnosis. According to a previous study, flow cytometric analysis of the cytoplasmic pattern of light-chain expression in mature B-cell neoplasms is a viable approach to confirming clonality. Herein, we report a case, in which clonality could not be proven by surface light-chain analysis, but was demonstrated by cytoplasmic light-chain analysis. The case was in a patient with B-cell lymphoma showing non-specific surface expression of light-chains. This case support consideration of flow cytometric analysis of cytoplasmic light-chain expression patterns when aberrant surface light chain expression is observed, to confirm clonality of mature B-cell neoplasms.
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